The purpose of this study is to determine the effectiveness of the implementation of the 1967 Amendments to Title V of the Social Security Act in four states. The study will assess the extent to which the policy objectives embodied in the transfer to the states of authority for the maternal and Infant Care and Children and Youth Projects were achieved. The effect of specific political and administrative factors on the implementation process will also be evaluated. The research design for this study establishes a set of hypotheses consisting of ten political and administrative preconditions which are considered essential for effective implementation. Study states will be chosen according to their degree of conformity with these preconditions. Data collected through existing documents, questionnaires and site visits to each of the four study states will be analyzed to determine the association between the degree of conformity with the hypothesized preconditions and the effectiveness of implementation in each state. A major contribution of this study will be to develop specific policy recommendations for improving the implementation and administration of maternal and child health policy and programs under Title V. The study will also serve to develop a better understanding of the importance of implementation for intergovernmental relations and the grants-in-aid system as these are critical to federal health policy.